INFLIXIMAB AND EMERGING BIOLOGICAL TREATMENT FOR PEDIATRIC CROHN'S DISEASE

Treatment of Crohn's disease (CD) is complex and based on different drugs. The biological treatments act on different stages of immunophysiopathological processes of the disease to change the evolution or natural history. The targets of these therapies, most of which are still experimental, and still off label in pediatrics, are highly selective and include proinflammatory cytokines, the CD4 positive T cells, the Thl and Th2 subgroups and adhesion molecules. At present monoclonal antibodies against TNF-a studied and/or used for Crohn's disease are four: a chimerical one (Infliximab), a 95% humanized one (CDP 571), a humanized and pegylated one (Certolizumab pegol) and finally a fully humanized type (Adalimumab). On the contrary, have been considered TNF-a recombinant receptors (Etanercept and Onercept) that have proven be ineffective for the treatment of active CD. The paediatric Crohn's is an early onset form of disease, that much better takes advantage of biological therapy compared with late onset adulthood forms.